Maternal and child healthcare is experiencing great challenges, as many physicians are becoming increasingly reluctant to serve high-risk populations. From 2004 to 2006, the Health Resources and Services Administration (HRSA) led a quality improvement effort known as the Perinatal and Patient Safety Pilot Collaborative (PPSPC) to improve perinatal patient safety and reduce the ethnic disparities in low birth weight and infant mortality, focused on the historically under-served and high-risk populations. Constructing individualized health plans require recognition that pregnancy and childbirth are an important part of a continuum of life experiences. A myriad of events and circumstances both prior and subsequent to pregnancy are invariably linked to the eventual outcome for women and their children. Improving efficiency and effectiveness of care requires greater communication among different providers and the various community networks. Greater effort and emphasis must be placed on recruiting and retaining the health profession’s workforce and training future family physicians as skilled in providing the full spectrum of maternal child healthcare.